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 | A Message from Regions president & CEO
The Minnesota Department of Health released its fourth annual Adverse Health Events (AHE) report for Minnesota hospitals on Jan. 17, 2008. The report discloses the number of 27 adverse events that have occurred in Minnesota hospitals and surgical centers from Oct. 7, 2006, through Oct. 6, 2007. The AHE reporting systems intent is to create a culture that promotes shared learning from relatively rare events and encourages collaboration on patient safety practices across hospitals.
Since reporting began in 2003, Minnesota hospitals have been working together to make care safer. For example, hospitals across the state, including Regions, adopted a hard stop policy that allows anyone in the operating room to stop a surgery if specific procedures arent followed.
Safety is, and always has been, a top priority at Regions Hospital. Providing a safe and healing environment is one our Promises to Patients and Families. Our hospital is dedicated to the new reporting system, and we are vigilantly working to make care safer for all patients.
Here are some examples of safety measures we have in place at Regions:
- We are participating in the Institute for Healthcare Improvements (IHI) 5 Million Lives Campaign, which is an initiative to protect patients from five million incidents of medical harm over the next two years (December 2006 December 2008).
- We are participating in important new Minnesota Hospital Association (MHA) patient safety campaigns introduced in 2007. These include the SAFE SKIN and SAFE from FALLS campaigns aimed at reducing the occurrence of preventable pressure ulcers (bedsores) and patient falls, respectively. As part of the SAFE SKIN campaign, for example, we recently began using turning clocks on some units. These turning clocks serve as a visual reminder for caregivers to turn a patient every two hours (or as ordered). Turning patients redistributes the weight of their limbs and helps prevent pressure ulcers.
- We are leading and/or participating in many initiatives designed to improve safety in operating rooms and procedure areas.
- We helped define protocols and are participating in the MHAs SAFE SITE campaign (also introduced in 2007). The campaign is designed to reduce the occurrence of wrong-site surgeries.
- Since 2004, we have been performing a time out in our operating rooms. The time out is designed to prevent surgical errors from occurring. As part of the process, the surgeon initials the correct site of the body and we verify patient identification and procedure before any surgery begins. In 2005, we began that same process in procedural areas outside of the OR.
- We are piloting pre-surgery communications briefings (in addition to time-outs) led by surgeons in our operating rooms.
- We have started to implement new protocols in the OR and in labor and delivery to prevent unintentional foreign object retention. The protocols were developed by a community-wide workgroup initiated by the Institute for Clinical Systems Improvement (ICSI) and led by our director of patient safety. The OR protocol, for example, includes such steps as counting objects in the exact same order before and after surgery and using post-surgery X-rays in high-risk, complex cases.
- We are also participating in a 10-hospital collaborative whose goal is to understand high-reliability principles and apply them in a surgical setting. This collaborative is co-led by our senior director of surgical services.
- Regions has developed a number of new safety measures that strengthen our communication between staff members, departments and multiple disciplines. These include:
- The patient transport pass, introduced in Oct. 2007, is issued to patients who must leave their units for tests, procedures and therapies within the hospital. The passes include important patient information should an emergency occur during transport.
- The bedside report is currently in the test stage and occurs during the change of shift. At that time, the incoming nurse and outgoing nurse discuss pertinent patient information at the patients bedside instead of in a separate report room. When possible, the patient participates in the bedside report as well.
- In Dec. 2007, we introduced the patient and family-activated Rapid Response Team (RRT). The RRT is an in-house emergency medical team which was first implemented at Regions in 2005. The team is called into action when someone in the hospital appears to be in danger of suffering a medical emergency, such as a heart attack. Prior to December, only staff members, physicians and volunteers could activate the Rapid Response Teams.
- We instituted mock Code IIs in behavioral health and labor and delivery. Code IIs are called when a patient is experiencing cardiac or respiratory arrest. Real Code IIs at Regions have declined due to the success of our Rapid Response Team, which comes to the aid of people before a medical emergency occurs.
- In December, remote telemetry was introduced at Regions. Remote telemetry enables patients to remain on units that specialize in their primary diagnosis while being monitored for heart problems.
- Our electronic medical record has helped us reduce medication errors. Medication errors have decreased by 48 percent following the implementation of computerized physician order entry (CPOE). CPOE eliminated the problem of illegible, hand-written orders and sends alert messages to help prevent adverse drug events (such as when a patient is allergic to a chosen drug).
- We continue to use the PINCH protocol, a medication safety measure that alerts staff to patients who are being administered one of five high alert IV drugs. This was first implemented in 2005.
- We now require visitors who come into the hospital after hours to wear identification badges with photos to help ensure the safety of our patients, visitors and staff.
- We have many other patient safety practices and procedures in place ranging from monthly safety rounds conducted by our executive board to competency training on various pieces of equipment and comprehensive restraints programs.
If you have concerns about patient safety at Regions, please call our director of patient safety at 651-254-0760.
Sincerely,
Brock Nelson
President and CEO
Regions Hospital
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